One of my most powerful learning moments came as a newly qualified occupational therapist back in the 1980s, when I was working in North Wales in a small cottage hospital for people with advanced dementia. One lady there, Hilda, appeared to be completely disengaged from her surroundings and spent all of her day sitting on a sofa with her eyes closed. I had never heard her speak and my belief was that Hilda was unable to do anything – but how wrong I was.
One day we had music playing in the background while patients and staff were working together on an art project. The Men of Harlech song came on, a very powerful and stirring piece. If you haven’t listened to it, find it on YouTube and have a listen. It will move your spirit. As soon as the introduction started, to our astonishment, Hilda rose from the sofa, clasped her hands in front of her and sang the lyrics all the way through perfectly in Welsh.
My lesson learned? If you find the right key you will unlock the potential that is waiting to be discovered. That key can be in many places of course, but music is a particularly effective tool to enable meaningful moments, because music is processed and stored in so many different parts of the brain.
Most activity providers know that if we know an individual’s musical preferences and history of any particular songs and tunes that relate to specific times, we can selectively use music to stimulate those memories as a reminiscence activity, and so, enhance self-identity. But music can do so much more.
Many of you will have seen the recent social media posting of a Prima Ballerina in her 90’s who is living with dementia. As she listens to Swan Lake, her movement memory is stimulated and she performs again with beauty and grace.
This ability to still be able to complete well-rehearsed movement is called procedural memory and results in what is known as a skill. So, when we know that a person has a skill, be it playing a musical instrument or dancing a classical ballet, providing the right music and opportunity will unlock that potential.
Music not only supports a sense of self, it also stimulates physical health – from providing rhythm for movement to providing rhythm for the heart rate. Even this knowledge can enable care providers to think carefully about the music that is available to support individuals; not only selecting the genre to suit individual preferences, but even choosing music with a beat to stimulate either relaxation or alertness. I have often noticed that calm, relaxing music is being played in care home dining rooms when, actually, something with a faster beat would support more active dining.
One of the most important observations I have made over my many years of working with people with dementia is that, whilst music itself can unlock the potential of individuals, it is often the accompanying social interaction that helps to reconnect the person with others. The joy of sharing music by singing or humming together, dancing together, playing an instrument together or simply tapping along or swaying to the beat – it is the togetherness that enhances the mood and nurtures the spirit.
QCS has several policies in place (including a care plan and risk assessment) for use when considering the use of meaningful music in everyday activity; for example, while helping the person to get dressed or to dine, as well as to support recreational activities. The National Activities Providers Association have some great ideas for supporting music-based activities, and the Royal College of Occupational Therapists, Living well through activity in care homes: the toolkit offers some great ideas for integrating activities and music.
I will always be grateful for my experience in North Wales and what it taught me about my own practice and also about the magic of music. How will you use music to reach your service users?
More about the author, Jackie Pool:
An experienced occupational therapist, Jackie has worked in a number of high profile roles for some of the country’s largest Health and Social Care providers. She is also a prolific national and international conference speaker and author of books and articles on the topic of dementia.
Jackie also works in academia, where she’s a researcher at the Universities of Manchester and Exeter and has collaborated with academics from Bangor University on a ground-breaking study, which assesses the impact of cognitive rehabilitation on those living with dementia.
As Dementia Care Champion, Jackie will play an integral role in helping QCS to create a progressive best practice dementia strategy for Health and Social Care Providers. QCS will also fully support Jackie to further advance her trailblazing PAL Instrument, which QCS has also acquired.
